PETER J ELLIS MD (Credential# 552144) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is July 1, 2020. The license expiration date date is June 30, 2021. The license status is ACTIVE.
PETER J ELLIS MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.034548. The credential type is physician/surgeon. The effective date is July 1, 2020. The expiration date is June 30, 2021. The business address is 34 Autumn St, New Haven, CT 06511-2221. The current status is active.
| Licensee Name | PETER J ELLIS MD |
| Credential ID | 552144 |
| Credential Number | 1.034548 |
| Credential Type | Physician/Surgeon |
| Business Address |
34 Autumn St New Haven CT 06511-2221 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 1995-06-09 |
| Effective Date | 2020-07-01 |
| Expiration Date | 2021-06-30 |
| Refresh Date | 2020-04-16 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 161152 | CSP.0023328 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 1999-03-01 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 34 AUTUMN ST |
| City | NEW HAVEN |
| State | CT |
| Zip Code | 06511-2221 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Merceditas S Villanueva Md | 34 Autumn St, New Haven, CT 06511-2221 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| David C Tate | 70 Autumn St, New Haven, CT 06511-2221 | Psychologist | 2019-09-01 ~ 2020-08-31 |
| Edward Fischer | 86 Autumn St, New Haven, CT 06511-2221 | Physician/surgeon | 2016-11-01 ~ 2017-10-31 |
| Laura C Berger | 50 Autumn St, New Haven, CT 06511-2221 | Master's Level Social Worker | 2016-09-01 ~ 2017-08-31 |
| Glyn Elizabeth L Lasater | 80 Autumn St, New Haven, CT 06511-2221 | Physical Therapist | 2015-01-01 ~ 2015-12-31 |
| Truman Gilbert Design LLC | 70 Autumn St, New Haven, CT 06511-2221 | Home Improvement Contractor | 2015-02-18 ~ 2015-11-30 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Montessori School On Edgewood Inc. | 230 Edgewood Avenue, New Haven, CT 06511 | Public Charity | 2019-06-01 ~ 2020-05-31 |
| Therese Parks · Visel Drug Store | 264 Munson St, New Haven, CT 06511 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Dazjia Monet Green | 115 Edgewood Ave Apt 64, New Haven, CT 06511 | Registered Nurse | 2020-06-27 ~ 2021-05-31 |
| Carol Yam | 343 Humphrey St, New Haven, CT 06511 | Registered Nurse | ~ |
| Marwan S Haddad | 38 Lincoln Street, New Haven, CT 06511 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Mary Lou Gaeta Md | 558 Chapel Street, New Haven, CT 06511 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Cary M Tucker | 64 Bishop St, New Haven, CT 06511 | Architect | 2020-08-01 ~ 2021-07-31 |
| Frank J Pannenborg | 505 Ellsworth Ave, New Haven, CT 06511 | Architect | 2020-08-01 ~ 2021-07-31 |
| Crystal E Gooding | 26 Woodland Street, New Haven, CT 06511 | Notary Public Appointment | 2020-07-01 ~ 2025-06-30 |
| Kieran Jones | 260 Crown St Unit 1f, New Haven, CT 06511 | Registered Nurse | ~ |
| Find all Licenses in zip 06511 | |||
| City | NEW HAVEN |
| Zip Code | 06511 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + NEW HAVEN |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Richard A Fraser | 5 Ellis Ct, Rye, NY 10580 | Physician/surgeon | 2010-12-01 ~ 2011-11-30 |
| Scott Ellis | 523 E 72nd St Fl 5, New York, NY 10021-4099 | Physician/surgeon | ~ |
| Ellen P Ellis | 30 Park Ave, New York, NY 10016 | Physician/surgeon | 1991-12-20 ~ 1992-12-31 |
| James H Ellis | 103 N Redbud Ct, Mahomet, IL 61853-9284 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Richard Ellis Md | 134 Birch Hill Rd, Weston, CT 06883 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Felix L Ellis | 4 Stuyvesant Oval, New York, NY 10009 | Physician/surgeon | 2002-01-31 ~ 2002-09-12 |
| Ellis A Perlswig | 30 Bryden Terr, Hamden, CT 06517 | Physician/surgeon | 2007-04-19 ~ 2008-03-31 |
| Wendy Drew Ellis | P. O. Box 660070, Birmingham, AL 35266 | Physician/surgeon | 2019-09-01 ~ 2020-08-31 |
| Michael Joseph Ellis | 47 Barberie Ave, Highlands, NJ 07732-1517 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Issam A Awad | 5801 S Ellis Ave, Chicago, IL 60637-5418 | Physician/surgeon | 2011-10-01 ~ 2012-09-30 |
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| Data Provider | Connecticut Department of Consumer Protection |
| Jurisdiction | Connecticut |
| Related Datasets | Connecticut Business Registrations, Connecticut Child Care Facilities |
This dataset includes 1.41 million licenses issued wtih Connecticut Department of Consumer Protection (TDLR).